SURGERY. 



SWEDEN AND NORWAY. 753 



neys, at the expense of a great deal of irrita^ 

 tion and congestion of the organ. The poison- 

 ous effects of the acid may occur in a certain 

 small number of cases, in spite of the best 

 management, and in such cases is the result of 

 a rare idiosyncrasy in those affected. Several 

 interesting cases may be cited in proof of this 

 statement. One in particular, from the practice 

 of Dr. Whiteford, which shows the peculiar 

 susceptibility possessed by the members of 

 some families, and also the small quantity 

 which will sometimes suffice to produce symp- 

 toms of poisoning. Two. children of one family 

 came under his care suffering from ringworm 

 of the scalp. The treatment in both cases was 

 a two -and -a -half -per -cent, solution of car- 

 bolic acid applied in the form of a water-dress- 

 ing. In both, symptoms of poisoning occurred, 

 in one case exceedingly severe, and coming on 

 very shortly after the first application, while 

 in the other the symptoms were delayed for 

 two days and were altogether less severe. Re- 

 moval of the acid removed all the symptoms in 

 both cases. To satisfy his mind that the acid 

 was really at fault, and that the symptoms were 

 not merely a coincidence, he repeated the ex- 

 periment twice in each case once to the scalp, 

 as before, and again to another part of the 

 body with the result of bringing back the 

 urinary and gastric disturbances and the other 

 symptoms of carbolic irritation. In none of 

 these applications did the size of the portion of 

 the skin in contact with the acid exceed that 

 of a half-dollar. The result of the study of 

 these cases has been to diminish the strength 

 of the solutions of carbolic acid, as well as the 

 frequency of their application, and also to 

 substitute other substances which answer the 

 purpose even better and are attended with less 

 danger, such as eucalyptus globulus, acetate of 

 aluminum, and bichloride of mercury. 



Erysipelas. The proof of the pathogenic na- 

 ture of the niicrococci of erysipelas has been 

 given by Fehleisen, who has not only found 

 them present in all cases of erysipelas exam- 

 ined during life, but also cultivated them, and 

 with equal success inoculated the cultivated 

 organisms in animals and in man. In small 

 portions of skin excised from the diseased part 

 in patients suffering w : th erysipelas he found 

 in all cases numerous micrococci arranged in 

 chains. They were especially abundant in the 

 parts most recently affected; and here they 

 were found most abundantly in the superficial 

 layer of the corium and in the subcutaneous 

 adipose tissue, filling the lymphatics and the 

 lymph-spaces, while the rest of the tissue 

 showed a cell-infiltration. Contrary to the older 

 observers, they were never found in the blood- 

 vessels. To prove that their presence was not 

 merely accidental, Fehleisen cultivated some 

 small excised portions of skin on gelatin, after 

 carefully disinfecting the affected part, and suc- 

 ceeded/in the course of two months, in pro- 

 ducing fourteen generations. The cultivated 

 micrococci formed a whitish film, easily de- 

 VOL. XXIH. 48 A 



tached from the surface of the gelatin, and 

 consisting entirely of the specific tnicrococcus. 

 Nine rabbits were inoculated on the ears with 

 the pure and cultivated organisms. In one the 

 effect was merely a slight elevation of tem- 

 perature ; in all the others, after thirty-six to 

 forty-eight hours, the temperature rose, and a 

 characteristic erysipelatous rash appeared and 

 gradually extended to the root of the ear, and 

 thence spread to the head and neck. Within 

 eight days the disease had run its course, and 

 the animal recovered. Not one of the animals 

 died. The light-red color of the affected part, 

 the absence of oadema or suppuration, and the 

 presence of the micrococci in the lymphatics 

 of the affected part (seen in one case where the 

 eor was amputated during the height of the 

 disease), showed that the affection was true 

 erysipelas, and not septicaemia. 



More valuable still to show the etiological 

 importance of the micrococci in erysipelas are 

 the inoculations on man. (Such a proceeding 

 was perfectly justifiable, when it is considered 

 that many of the older surgeons have quoted 

 cases showing the curative and beneficial effect 

 of erysipelas when occurring in cases of a more 

 serious nature, as cancer and lupus.) Fehl- 

 eisen inoculated the pure and cultivated micro- 

 cocci in seven patients, all suffering from severe 

 and incurable disease. Six out of the seven 

 cases showed, after a period of incubation vary- 

 ing from 15 to 60 hours, typical erysipelas, set- 

 ting in with chills and high temperature, and 

 running the characteristic course. In some the 

 symptoms were very -severe, in one there was 

 threatening collapse, and one was complicated 

 with pleurisy, which, however, soon subsided. 

 As regards the therapeutic effect, the inocula- 

 tions are of some interest. One case of lupus 

 was almost entirely cured. In another case the 

 cancerous tumors completely disappeared, and 

 there had been no recurrence. 



The effect of antiseptics on the vitality of 

 the micrococci was also tried. Two substances 

 only were experimented with carbolic acid and 

 corrosive sublimate. A three-per-cent. solu- 

 tion of the former stopped the growth of the 

 micrococci after a contact of 45 seconds, while 

 the same effect was produced in 15 seconds 

 with a one-per-cent. solution of the corrosive 

 sublimate. The list of diseases due to a spe- 

 cific organism is thus increased by one. 



SWEDEN AND NORWAY, two kingdoms occu- 

 pying the Scandinavian Peninsula in Northern 

 Europe, united indissolubly, by the Riksact of 

 1815, in the person of the sovereign. Succes- 

 sion to the throne is hereditary in the house of 

 Ponte Corvo. The throne is to be filled, in 

 case of absolute vacancy, by the joint action 

 of the two Parliaments. The common affairs 

 of both kingdoms are decided upon by a Coun- 

 cil of State. 



The reigning King is Oscar II, born Jan. 21, 

 1829, grandson of Marshal Bernadotte, and the 

 fourth sovereign of the line. 



SWEDEN. Constitution. The legislative pow- 



